Stress and Diabetes - Part 2

Reducing Mental Stress

Making changes
For some problems, stress may be a sign that something needs to change. With change, you may be able to get rid of some stresses of life. If traffic upsets you, for example, maybe you can find a new route to work or leave home early enough to miss the traffic jams. If your job demands too much from you, you can possibly discuss with your boss how to improve things. If you are in conflict with a friend or relative, you can make the first move to make up.

There are other ways to fight stress as well:
                                                                    

Start an exercise program or join a sports team.

                                                                 

Take dance lessons or join a dancing club.

                                                              

Start a new hobby or learn a new craft.

                                                               

Volunteer at a hospital or charity, or NGO.

Coping Style

Coping style is how a person deals with stress. For example, some people have a problem-solving attitude. They say to themselves, "What can I do about this problem?" They try to change their situation to get rid of the stress.

Other people talk themselves into accepting the problem as okay. They say to themselves, "This problem really isn't so bad after all."

These two methods of coping are usually helpful. People who use them tend to have less blood glucose elevation in response to mental stress.

Learning to Relax

For some people with diabetes, controlling stress with relaxation therapy seems to help, though it is more likely to help people with Type 2 diabetes than people with Type 1 diabetes. This difference makes sense. Stress blocks the body from releasing insulin in people with type 2 diabetes, so cutting stress may be more helpful for these people. People with type 1 diabetes don't make insulin, so stress reduction doesn't have this effect. Some people with type 2 diabetes may also be more sensitive to some of the stress hormones. Relaxing can help by reducing this sensitivity.

There are many ways to relax

Breathing exercises

Sit or lie down and uncross your legs and arms. Take in a deep breath. Then push out as much air as you can. Breathe in and out again, this time relaxing your muscles on purpose while breathing out. Keep breathing and relaxing for 5 to 20 minutes at a time. Do the breathing exercises at least once a day.

Progressive relaxation therapy

In this technique, which you can learn in a clinic or from an audio tape, you tense muscles, then relax them.

Exercise

Another way to relax your body is by moving it through a wide range of motion. Three ways to loosen up through movement are circling, stretching, and shaking parts of your body. To make this exercise more fun, move with music.

Replace bad thoughts with good ones

Each time you notice a bad thought, purposefully think of something that makes you happy or proud.

Whatever method you choose to relax, practice it. Just as it takes weeks or months of practice to learn a new sport, it takes practice to learn relaxation.

Stress and Diabetes - Part 1

Stress can be physical or mental.

Most people get stressed when physical conditions like injury or illness or mental conditions like problems in relationships, job, health, or finances cause their bodies to behave as if it were under attack.

When stress strikes, the body prepares to take action. This preparation is called the fight- freeze or-flight response. In the fight-freeze or flight response, levels of many hormones shoot up and make a lot of stored energy — glucose and fat — available to cells so that they can help the body get away from danger.

 What is the fight-freeze or flight response?

The fight-freeze or flight response is a mechanism which helps us to deal with threats and stressful situations.

When faced with a threat, one automatically gets ready to either freeze or  stop in shock, fight the threat or make a quick escape. The level of blood sugar for energy increases, blood pressure increases to take fresh oxygen to working muscles and adrenalin is released for better concentration and alertness.

What can cause stress?
 

Every- day stresses such the stress of a job, meeting deadlines, economic uncertainty, maintaining social relationships and the demands of raising children all activate the same fight –freeze or flight response.

Stress can result in Type 2 diabetes

Different forms of emotional stress increase the risk of occurrence of diabetes and also its advancement.

Emotional stress, especially depression, general emotional stress, anxiety, anger/hostility, and sleeping problems can increase the risk for the development of type 2 diabetes in 2 ways. The first is through behavioural changes such as unhealthy lifestyle behaviours, - poor food habits in terms of quality and quantity of food, low exercise levels, smoking and alcohol abuse (Bonnet et al., 2005; Rod et al., 2009). 

The other is through physiological changes that result in abdominal obesity (Björntorp, 2001; Vogelzangs et al., 2008) and other changes in immune system activity (Leonard and Myint, 2009), (Anisman, 2009).

All these factors are well-known risk factors for the development of Type 2 diabetes.

We still know very little about the mechanisms by which different forms of emotional stress increase the risk of diabetes incidence and progression. It is important for future research to explore these and other potential pathways in detail.

How Stress Affects Diabetes

In people who have diabetes, the fight-freeze or-flight response does not work well. Insulin is not always able to let the extra energy into the cells, so glucose piles up in the blood.

Many sources of stress are long-term threats. For example, it can take many months to recover from surgery. Stress hormones that are designed to deal with short-term danger stay turned on for a long time. As a result, long-term stress can cause long-term high blood glucose levels. With mental stress, the body pumps out hormones for no useful purpose. Neither fighting nor fleeing is any help when the "enemy" is your own mind.

In people with diabetes, stress can alter blood glucose levels in two ways:

People under stress may not take good care of themselves. They may drink more alcohol or exercise less. They may forget, or not have time, to check their glucose levels or plan good meals or take medication.

Stress hormones may also alter blood glucose levels directly.

In people with type 2 diabetes, mental stress often raises blood glucose levels. Physical stress, such as illness or injury, causes higher blood glucose levels in people with either type of diabetes.

  Find out whether mental stress affects your glucose control    

Before checking your glucose levels, write down a number on a rating scale of 1 to 10 ranking your mental stress level. Then write down your glucose level next to it. After a week or two, look for a pattern. Drawing a graph may help you see trends better. Do high stress levels often occur with high glucose levels, and low stress levels with low glucose levels? If so, stress may affect your glucose control.

Source:
http://www.diabetes.org
http://www.discoverymedicine.com
            

TRANS- FATTY ACID AND HEALTH PROBLEMS

Karthika & Sheela Paul
Dietitians - MVH 

There has been a lot of focus on the need to avoid  trans-fatty acids . To understand why you should avoid trans-fats, it's important to understand what they are and what they can do to your overall well-being. 

 They are unsaturated fats that contain trans-isomer fatty acids which in turn are a by-product of the hydrogenation process. When unsaturated fats are hydrogenated, to make margarine or vegetable shortening, for example, trans-fatty acids are created in that process. This process was developed years ago as a way of keeping fats from spoiling and  to improve flavour.

Studies have shown that diets high in Trans- fats lead to health problems such as stroke, diabetes and coronary heart disease. There is even more evidence that these foods help to contribute to cancer, obesity, infertility and liver dysfunction. With all these negative effects, it’s better to avoid a diet high in these fats.

What are these foods that we should avoid? Processed foods, as well as every kind of fast food available have high levels of trans-fats. . While many of these foods taste good, and are easy to make meal of, they   are harmful for the  body. The American Heart Association has advised limiting trans- fat consumption to less than 1% but it is better to cut it out entirely from the diet. Though this may be difficult at first, once you avoid these processed foods , you won’t miss them much.

Animal products do contain trans-fats, but the main  source  of trans-fatty acids  in the diet is from  partially hydrogenated vegetable oils, such as margarine or the oils used to fry fast foods. These trans-fatty acids are not essential to our body's needs, and they do not promote good health as other fats may do. Studies show that trans-fats raise levels of LDL (bad cholesterol) in the body, at the same time lowering HDL (good cholesterol). This can lead to a many health problems.

Studies show a link between trans-fats and the onset of Alzheimer's Disease and obesity. Overconsumption can lead to liver disease, infertility and the development of cancer and type 2 diabetes.

A diet that includes monounsaturated fats such as olive oil, avocadoes and safflower or sunflower oil is considered the healthiest way to eat.

Trans Fat Labeling on Foods

Look at the  nutritional facts, as well as at the  ingredients list. Anything that contains “partially hydrogenated” oil contains Trans- fat. Though it may only be a small amount, these fats add up quickly.  

Foods to Avoid
Originally created to enhance flavor, extend shelf life and improve texture, these fats are present in a many foods that people take on a daily basis.

You should look for Trans- fats in any of these products:

• Cookies
• Crackers
• Cakes
• Muffins
• Pie crusts
• Pizza dough  
• Margarine    
• Vegetable shortening
• Cake mixes
• Pancake mixes
• Chocolate drink mixes
• Donuts
• French fries
• Potato chips
• Candy
• Packed popcorn
• Frozen dinners       

Because most of the foods that contain trans- fats are snack foods, even without containing trans- fats, they are not necessarily nutritionally sound. They are often loaded with empty calories and should be avoided regardless.

The only way to have a truly healthy diet is to eat a wide mix of fruits, vegetables and whole grains.